“Hospital Medicine” has been defined as a medical specialty dedicated to the delivery of comprehensive medical care to hospitalized patients. Practitioners of hospital medicine include physicians (“hospitalists”) and non-physician providers who engage in clinical care, teaching, research, or leadership in the field of general hospital medicine. In addition to their core expertise managing the clinical problems of acutely ill, hospitalized patients, hospital medicine practitioners work to enhance the performance of hospitals and healthcare systems.
Hospitalists strive for this goal by: (1) providing Prompt and complete attention to all patient care needs including diagnosis, treatment, and the performance of medical procedures (within their scope of practice), (2) employing quality and process improvement techniques, (3) supporting collaboration, communication, and coordination with all physicians and healthcare personnel caring for hospitalized patients, (4) transitioning safely patient care within the hospital, and from the hospital to the community, which may include oversight of care in post-acute care facilities, (5) using hospital and healthcare resources efficiently.
“Hospitalist” is the term used for doctors who are specialized in the care of patients in the hospital. Following medical school, hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice, but may also receive training in other medical disciplines. Some hospitalists undergo additional post residency training specifically focused on hospital medicine, or acquire other indicators of expertise in the field, such as the Society of Hospital Medicine's Fellowship in Hospital Medicine (FHM) or the American Board of Internal Medicine's Recognition of Focused Practice (RFP) in Hospital Medicine.
Factors favoring this specialization include convenience, efficiency, financial strains on primary care doctors, patient safety, cost-effectiveness for hospitals, and need for more specialized and coordinated care for hospitalized patients. Most hospitalists are board-certified internists (internal medicine physicians) who have undergone the same training as other internal medicine doctors including medical school, residency training, and board certification examination.
Hospitalists usually have chosen not to practice traditional internal medicine due to personal preferences, while some hospitalist physicians are family practice doctors or medical subspecialists who have opted to do hospitalist work such as, intensive care doctors, lung doctors (pulmonologists), or kidney doctors (nephrologists). Hospitalist specialties include:                (1) a Neurohospitalist: Many hospitals, particularly those with dedicated stroke centers, are adding neurohospitalists to their staff. Not only are they able to handle complex cases quickly, but hospitals don't have to pay the pricey fees to bring in a neurologist on call,        (2) Surgical Hospitalist (a.k.a. Surgicalist): These hospitalists started out as a solution to overcrowded emergency departments. They were brought in to provide timely surgical consults and get patients into surgery quickly, increasing throughput. But the concept stuck, and many hospitals are adding this position as a part of their staff,        (3) OB Hospitalists (a.k.a. Laborists): More hospitals are moving toward using laborists. They're able to oversee a labor until the mother's regular OBGYN can make it to the hospital. And because they can more effectively manage tough labors and deliveries, they can reduce a hospital's C-section rate, and        (4) Dermatological Hospitalists: These specialists are integrating themselves back into the inpatient setting after long being a predominately office-based specialty. They can be called upon for a number of cases spanning from adverse drug reactions to stem cell transplant complications.        
There are many advantages of hospitalists in the care hospitalized patients. One advantage is that hospitalists' have more expertise in caring for complicated hospitalized patients on a daily basis. They are also more available most of the day in the hospital to meet with family members, able to follow-up on tests, answer nurses' questions, and simply to deal with problems that may arise. In many instances, hospitalists' may see a patient more than once a day to assure that care is going according to plan, and to explain test findings to patients and family members.
Hospitalists also coordinate the care of patients' in hospital, which means they are the physicians that organize the communication between different doctors caring for a patient, and serve as the point of contact for other doctors and nurses for questions, updates, and delineating a comprehensive plan of care. They are also the main physician for family members to contact for updates on a loved one.
Similarly, because hospitalists are in the hospital most of the time, they are able to track test results and order necessary follow-up tests promptly. This is in contrast to the traditional setting where your primary doctor may come to the hospital the next day to follow-up the results and take the next necessary step at that time.
Since the hospitalist's “office” is the hospital, and they are also more familiar with the hospital's policies and activities. Many hospitalists are involved in various hospital committees, and assist in improving important areas such as patient safety, medical error reduction, effective communication between physicians and staff, and cost effective patient care. The main disadvantage of having a hospitalist take care of you in the hospital is that, they may not know your detailed medical history as well as your primary doctor. Another problem is that your primary care doctor may not have access to the details of your hospitalization care (tests, procedures, results, medications, medical plan of action, etc.). These problems have been dealt with to a degree by communication between the primary care doctor and the hospitalist, which usually, and ideally, takes place at least twice during a hospitalization, once upon admission and again prior to discharge from the hospital.
As inpatient cases become more complex, hospitals around the country are likely to add more “hyphenated hospitalists” in the near future. The New York Times Jane Gross puts the spotlight on Hospital Medicine with her recent article: “New Breed of Specialists Signs in for Family Doctor.” With patients still largely confused or even ignorant of the role of Hospitalists, Gross' article explains, in lay terms, how hospitalists fit into new models of health care delivery: “Because hospitalists are on top of everything that happens to a patient—from entry through treatment and discharge—they are largely credited with reducing the length of hospital stays by anywhere from 17 to 30 percent, and reducing costs by 13 to 20 percent, according to studies in The Journal of the American Medical Association.” This article also states that “As their numbers have grown, from 800 in the 1990s to 30,000 today, medical experts have come to see hospitalists as potential leaders in the transition to the Obama administration's health care reforms, to be phased in by 2014.” And, “[u]nder the new legislation, hospitals will be penalized for readmissions, medical errors and inefficient operating systems.” and “[a]voidable readmissions are the costliest mistakes for the government and the taxpayer, and they now occur for one in five patients, gobbling $17.4 billion of Medicare's current $102.6 billion budget.”
As the demand for Hospitalists continues to grow, issues regarding the quality and thoroughness of hospitalist documentation are becoming increasingly important. Hospitals and hospitalist medicine providers are also finding themselves facing regulations mandating that they provide more timely and consistent documentation. There is a current need for a method and system to efficiently and consistently tracks hospitalist performance and productivity while providing a clinical workflow and communication tool between the provider, provider partners and the hospitals they practice in.